The Dramatic Season Finale of Black-ish Was All About Preeclampsia, and They Got Everything Right

A good pregnancy storyline is practically required for TV sitcoms. But while most shows go for laughs, the season finale of Black-ish, which aired Wednesday night,went in a way more serious direction—addressing a scary pregnancy complication that strikes a substantial number of mothers-to-be yet is never makes it to primetime.

In the episode, Rainbow (Tracee Ellis Ross) and husband Dre (Anthony Anderson) are planning a baby shower to celebrate the impending birth of their fifth child. Rainbow decides to visit the doctor because she’s been having headaches. That’s when the action shifts from a funny coed baby shower scene into a high-stakes emergency delivery.

As Dre puts it in the show, “You know that face the flight attendant makes when something’s not right, but they can’t tell you what? That’s the face Bow’s doctor had when she walked through that door.”

The doctor says that Rainbow has preeclampsia, a condition that causes extremely high blood pressure and can give a pregnant woman seizures, cause organ damage and placental separation, and in same cases even be fatal (for the baby as well). Rainbow is told she needs an emergency C-section, even though her due date is two months away. Rainbow, a doctor herself, addresses preeclampsia as well, explaining that the cause of preeclampsia isn’t known.

Health checked in with Mary Jane Minkin, MD, clinical professor of ob-gyn at Yale School of Medicine, to see if Black-ish covered preeclampsia accurately. Minkin says yes. The condition is usually caught in the later stages of pregnancy, as Rainbow’s was, and signs include swelling, very high blood pressure, and the intense headaches Rainbow experienced.

“It’s an entirely plausible storyline,” Minkin says. “It’s true, we don’t know what causes it. And in a worst-case scenario, the mother could die, and the baby could die. Fortunately in the United States, that doesn’t happen very often." Though most women with preeclampsia will deliver healthy babies and recover, it's the leading cause of premature birth and low birth weight in the U.S, and an estimated 3% to 5% of pregnant women will experience it.

Minkin says African-American women like Rainbow are more likely to have preeclampsia because they at greater odds statistically of having high blood pressure, a risk factor for the condition. And as Black-ish made clear, usually the only cure is delivering the baby, Minkin says. If the pregnancy is still in the first or second trimester, bed rest and close monitoring by doctors is an option.

As for Rainbow and Dre, the dramatic storyline concluded with the birth of their healthy (though premature) son, Devonte. With preeclampsia behind them, we can’t wait to see how this quirky family, especially busy working parents Rainbow and Dre, handles their new edition next season.